Everybody’s talking: I can’t hear a word they’re saying…

By Steve MacArthur, Hospital Safety Consultant

Something of a mixed bag of stuff this week, which is sometimes the case, particularly with the ever-shifting compliance landscape. First up, an update to one of TJC’s safety alerts dealing with the management of behavioral health patients in the ED, mostly as it relates to strategies of keeping things moving, and if they’re not moving, keeping things on a (relatively) even keel when inpatients beds are limited supply (which is pretty much all the time, though the degree to which that impacts ED patient flow is distinctly variable). If you’ve not had a discussion relative to the management of behavioral health patients in your ED (and I would certainly understand that pandemic response might just have caused a re-prioritization of discussions and conversations of all manner and variety), it’s probably worth checking out the updated materials with a small group and seeing if there are any improvement opportunities to be had. As with all such things, it’s never really about a “one size fits all” approach, but, in recognition that interpretations of compliance on the part of surveyors is often based on published content, at the very least it puts you in a better position having had the conversation about the “suggestions.” There are no magic bullets for any of this stuff and what works in some areas, works not so well in others, but it never hurts to see what’s in the minds of others (so to speak).

Closing out the week with a couple of COVID-related resources for your consideration. One of the hallmarks of the last 15-18 months of pandemic response has been the modification of existing facilities to support the medical management of infectious patients, etc. While there may have been some “casting about” for answers at the outset/onset of the pandemic, adjustments were made and life went on. But what if you had a facility that was specifically designed for such an event? I don’t know that anyone was sitting that “pretty,” but there’s been a lot of thought put into the design of the next iteration of healthcare facilities. For a glimpse of where things could be headed, there was an article in Health Facilities Management in July that discusses a lot of design considerations. My thought is that some of these might be useful in planning how to manage things in the shorter term (I somehow suspect that we are not all going to get new facilities any time soon) and if you’ve got some renovations in the not-too-distant future, you might find something useful to discuss with the architecture planning folks. For good or ill, we’ve never had so much practical experience as it relates to the management of pandemics, so let’s put it to good use. And just as I finished typing this post, the October 2021 issue of Health Facilities Management showed up in my inbox, featuring an article entitled “Designing The Post-Pandemic Hospital,” so there’s more information to consider. Much of it I suspect you already know, but it’s always good to see that you are not alone in thinking about this stuff.

Another component of pandemic response is the management of medical waste in the time of COVID; as with all such things, guidance is very fluid, but it’s worth bookmarking the Healthcare Environmental Resource Centers COVID medical waste page. There’s some state-specific information on the page as well as a link to a page where you can check on regulations in your home state. I suspect that the information contained therein will be in a near-constant state of update, so checking in on a regular basis is probably a good idea.

About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at stevemacsafetyspace@gmail.com.

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Environment and Facilities